Stellman S D, Djordjevic M V, Britton J A, Muscat J E, Citron M L, Kemeny M, Busch E, Gong L
Divisions of Epidemiology, American Health Foundation, Valhalla, New York 10595, USA.
Cancer Epidemiol Biomarkers Prev. 2000 Nov;9(11):1241-9.
To assess a possible etiological role of organochlorine compounds in breast cancer development on Long Island, a high-risk region of New York State, concentrations of organochlorine pesticides and polychlorinated biphenyls (PCBs) were measured in the adipose tissue of 232 women with breast cancer and 323 hospital controls admitted to surgery for benign breast disease or non-breast-related conditions. Seven pesticide residues and 14 PCB congeners were assayed via a supercritical fluid extraction method followed by gas chromatography with electron capture detection. After adjustment for age and body mass index, which were strongly correlated with organochlorine levels, adipose concentrations of 1,1-dichloro-2,2-di(4-chlorophenyl)ethylene, total pesticides, and total polychlorinated biphenyls (PCBs) did not differ significantly between cases and controls. The relative abundance of individual pesticide species and PCB congeners was similar in cases and controls. Odds ratios adjusted for age, BMI, hospital, and race gave no evidence of a dose-response for 1,1-dichloro-2,2-di(4-chlorophenyl)ethylene, total pesticides, or total PCBs, whether stratified by estrogen receptor status or not. Breast cancer risk among Long Island residents was not elevated compared with residents of the adjacent New York City borough of Queens. We did not confirm a previously reported association between breast cancer risk and levels of PCB congener 118 (2,3',4,4',5-pentachlorobiphenyl), nor did we observe an association with the most abundant congener 153 (2,2',4,4',5,5'-hexachlorobiphenyl), a strong inducer of phase I enzymes that was reported recently to have estrogenic properties. Only PCB congener 183 (2,2',3,4,4',5',6-heptachlorobiphenyl), which is also an inducer, was significantly associated with risk, with an adjusted odds ratio of 2.0 (95% confidence interval, 1.2-3.4) in women with adipose levels >5.67 ng/g; the biological importance of this observation is unclear without confirmation in additional studies. Although neither the present nor other studies have provided convincing evidence of an association between body burden of 1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane and PCBs with cancer of the breast, these compounds are rated as "possible" and "probable" human carcinogens, respectively, by the International Agency for Research on Cancer. Investigations of associations with cancer at other sites should be carried out.
为评估有机氯化合物在纽约州高风险地区长岛乳腺癌发病中可能的病因学作用,对232例乳腺癌女性患者及323例因良性乳腺疾病或非乳腺相关疾病接受手术的医院对照者的脂肪组织中有机氯农药和多氯联苯(PCBs)的浓度进行了测量。通过超临界流体萃取法,随后采用带电子捕获检测的气相色谱法测定了7种农药残留和14种多氯联苯同系物。在对与有机氯水平密切相关的年龄和体重指数进行校正后,病例组和对照组之间1,1 - 二氯 - 2,2 - 二(4 - 氯苯基)乙烯、总农药和总多氯联苯的脂肪浓度无显著差异。病例组和对照组中各农药种类和多氯联苯同系物的相对丰度相似。经年龄、体重指数、医院和种族校正后的比值比未显示1,1 - 二氯 - 2,2 - 二(4 - 氯苯基)乙烯、总农药或总多氯联苯存在剂量反应关系,无论是否按雌激素受体状态分层。与纽约市皇后区相邻的长岛居民的乳腺癌风险并未升高。我们未证实先前报道的乳腺癌风险与多氯联苯同系物118(2,3',4,4',5 - 五氯联苯)水平之间的关联,也未观察到与最丰富的同系物153(2,2',4,4',5,5' - 六氯联苯)的关联,153是一种I相酶的强诱导剂,最近报道具有雌激素特性。只有同样作为诱导剂的多氯联苯同系物183(2,2',3,4,4',5',6 - 七氯联苯)与风险显著相关,脂肪水平>5.67 ng/g的女性校正后的比值比为2.0(95%置信区间,1.2 - 3.4);在没有其他研究证实的情况下,这一观察结果的生物学重要性尚不清楚。尽管目前的研究和其他研究均未提供令人信服的证据表明1,1,1 - 三氯 - 2,2 - 双(4 - 氯苯基)乙烷和多氯联苯的体内负荷与乳腺癌之间存在关联,但国际癌症研究机构分别将这些化合物列为“可能”和“很可能”的人类致癌物。应开展与其他部位癌症关联的调查。